Frank Sztuk of Hanover Insurance was elected co-chair of the Coalition Against Insurance Fraud (CAIF).

Sztuk is Hanover's national SIU strategist director and haschaired the Massachusetts Fraud Bureau (MFB).

He will share Coalition leadership with incumbent co-chairSteve Perry, head of the D.C. Department of Insurance (DISB),Securities and Banking. John Sargent, manager-SIU of MetLife,serves as treasurer, and secretary is Ralph Burnham, executive director of the Pennsylvania Insurance Fraud Prevention Authority (IFPA).

Sztuk was elected during the CAIF's annual membership meetingthat included more than 90 executives from the insurance, consumerand government communities. It was a CAIF record.

Elected to the executive committee were: Bill Newton, head ofthe Florida Consumer Action Network (FCAN); James Doyle, vicepresident of investigations at Prudential Insurance; and Steve Rutzebeck, director of claimssecurity at Geico.

Elected to the board was Dominic Dugo, office of San DiegoCounty Attorney General.

An ambitious year of anti-fraud research also was unveiled.Among the new initiatives:

• Benchmarking study of insurer anti-fraud efforts
• Study of point-of-purchase fraud, especially via the Internetand telephone
• Guide to anti-fraud technology used by insurers and governmentagencies
• Study of state fraud bureau initiatives curbing no-fault auto fraud in hard-hit states is a CAIF legislativepriority.

The CAIF will seek passage of much-needed no-fault reforms inFlorida and New York. Staged crashes are rampant in those states, withbogus injury claims driving up premiums. Michigan is on the watch list of potential targeted no-faultstates.

Protecting consumers from scams is a longtime Coalition priority. The group will identifya key anti-fraud con that endangers large numbers of consumers, andlaunch an extended outreach campaign to alert the public.

With social media as a key avenue of communication for millions ofAmericans, the CAIF will expand its active Facebook and Twitter efforts, and launch several YouTube videos.

Contractor fraud and stepped-up efforts by Medicare and Medicaid to thwart widespread bilking of thegovernment programs were key discussion items in presentations bysenior fraud fighters.

Shady contractors are a large problem around the U.S., saysPhae Howard, executive director of the National Center for thePrevention of Home Improvement Fraud (NCPHIF), in Atlanta.Fraudulent insurance claims, illegal contracts, shoddy material andworkmanship, cost over-runs and identity theft are among theschemes.

Accurate data are hard to find, however, in part because victimsare too embarrassed to report scams to the police. Consumers canbecome their own quality-control managers by educating themselveshow to avoid being fooled by cheating contractors, Howardexplains.

Medicare and Medicaid are rapidly changing their pay-and-chasemodel to more assertive fraud prevention and detection, says PeterBudetti, deputy administrator for program integrity at the Centers for Medicare and Medicaid Services (CMMS).

Medical providers are being screened more closely, with the badactors weeded out. Powerful predictive analytics software also isbeing installed to better detect potential schemes, Budettisays.

Source: CoalitionAgainst Insurance Fraud